Lake Shore Podiatry Center, Llc in Chicago - Primary Podiatric Medicine
Lake Shore Podiatry Center, Llc - NPI 1366548018
Lake Shore Podiatry Center, Llc is a Primary Podiatric Medicine in Chicago, Illinois. Lake Shore Podiatry Center, Llc practices all healthcare services and medical treatments related to Primary Podiatric Medicine. The NPI Number for Lake Shore Podiatry Center, Llc is 1366548018. The last update date is 2008-07-17.
Lake Shore Podiatry Center, Llc's current location address is 4733 N Damen Ave, Chicago, Illinois. You can contact this provider via phone number 7738712250 and fax number 7736970134. The mailing address for Lake Shore Podiatry Center, Llc is 4733 N Damen Ave, Chicago, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Lake Shore Podiatry Center, Llc |
|---|---|
| Address | 4733 N Damen Ave, Chicago, Illinois |
| Phone Number | 7738712250 |
| Fax Number | 7736970134 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | MEDICAL DI |
|---|---|
| Authorized Official Name | Massuda Fortunee |
| Credentials | DPM |
| Telephone Number | 7732333800 |
NPI Number Detail
| NPI Number | 1366548018 |
|---|---|
| Provider Enumeration Date | 2006-09-16 |
| Last Updated Date | 2008-07-17 |
Provider Mailing Address Detail
| Address | 4733 N Damen Ave |
|---|---|
| City | Chicago |
| State | Illinois (IL) |
| Post Code | 606251442 |
| Phone Number | 7738712250 |
| Fax Number | 7736970134 |
Provider's Primary Taxonomy Detail
| Speciality | Primary Podiatric Medicine |
|---|---|
| Taxonomy | 213Ep1101X |
|
Definition: A doctor of podiatric medicine expert in general podiatry health services related to medical diagnoses and treatment of the foot, ankle and lower extremities. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 216-22095 | IL | BCBS |
Post Comment/ Review Below
What is the Lake Shore Podiatry Center, Llc's unique identification number?
The Lake Shore Podiatry Center, Llc has been assigned the NPI (National Provider Identifier) Number 1366548018 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you provide the complete address where Lake Shore Podiatry Center, Llc is physically located?
The Lake Shore Podiatry Center, Llc is situated at the following address: 4733 N Damen Ave, Chicago, IL 606251442.
What is Lake Shore Podiatry Center, Llc's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Lake Shore Podiatry Center, Llc's specialized field of practice is Primary Podiatric Medicine, and the corresponding taxonomy code that categorizes this area of specialization is 213Ep1101X.
On what date did the Centers for Medicare & Medicaid Services assign the 1366548018 to Lake Shore Podiatry Center, Llc?
The Centers for Medicare & Medicaid Services assigned the 1366548018 to Lake Shore Podiatry Center, Llc on 2006-09-16.
When was the information regarding Lake Shore Podiatry Center, Llc, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Lake Shore Podiatry Center, Llc, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2008-07-17.